镍敏感性的流行病学：1994-2014 年北美接触性皮炎组数据的回顾性横断面分析。

Epidemiology of nickel sensitivity: Retrospective cross-sectional analysis of North American Contact Dermatitis Group data 1994-2014.

机构信息

Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota; Department of Dermatology, University of Minnesota, Minneapolis, Minnesota.

University of Minnesota Medical School, Minneapolis, Minnesota.

出版信息

J Am Acad Dermatol. 2019 Mar;80(3):701-713. doi: 10.1016/j.jaad.2018.09.058. Epub 2018 Oct 18.

DOI:10.1016/j.jaad.2018.09.058

PMID:30342160

Abstract

BACKGROUND

Nickel is a common allergen.

OBJECTIVE

To examine the epidemiology of nickel sensitivity in North America.

METHODS

Retrospective, cross-sectional analysis of 44,097 patients patch tested by the North American Contact Dermatitis Group from 1994 to 2014. Nickel sensitivity was defined as a positive patch test for nickel. We evaluated the frequency of nickel sensitivity and patient demographics. For each positive reaction to nickel, we tabulated clinical relevance, occupational relatedness, and exposure sources.

RESULTS

The average frequency of nickel sensitivity was 17.5% (1994-2014). Nickel sensitivity significantly increased over time (from 14.3% in 1994-1996 to 20.1% in 2013-2014 [P < .0001]). Nickel-sensitive patients were significantly more likely to be female, young, nonwhite, and atopic (have eczema and asthma) and/or have dermatitis affecting the face, scalp, ears, neck, arm, or trunk (P values ≤ .0474). Overall, 55.5% of reactions were currently clinically relevant; this percentage significantly increased over time (from 44.1% in 1994-1996 to 51.6% in 2013-2014 [P < .0001]). The rate of occupational relatedness was 3.7% overall, with a significant decrease over time (from 7.9% in 1994-1996 to 1.9% in 2013-2014 [P < .0001]). Jewelry was the most common source of nickel contact.

LIMITATIONS

Tertiary referral population.

CONCLUSIONS

Nickel allergy is of substantial public health importance in North America. The frequency of nickel sensitivity in patients referred for patch testing has significantly increased over a 20-year period.

摘要

背景

镍是一种常见的过敏原。

目的

研究北美地区镍敏感性的流行病学情况。

方法

对 1994 年至 2014 年期间北美接触性皮炎组对 44097 名患者进行的回顾性、横断面分析。镍敏感性定义为对镍的阳性斑贴试验。我们评估了镍敏感性和患者人口统计学特征的频率。对于每一个对镍的阳性反应，我们列出了临床相关性、职业相关性和暴露源。

结果

镍敏感性的平均频率为 17.5%（1994-2014 年）。镍敏感性随时间显著增加（从 1994-1996 年的 14.3%增加到 2013-2014 年的 20.1%[P<0.0001]）。镍敏感患者更有可能是女性、年轻、非裔美国人、亚裔美国人、西班牙裔美国人或其他少数族裔、有特应性皮炎（湿疹和哮喘）和/或面部、头皮、耳朵、颈部、手臂或躯干有皮炎（P 值≤0.0474）。总体而言，55.5%的反应目前具有临床相关性；这一比例随时间显著增加（从 1994-1996 年的 44.1%增加到 2013-2014 年的 51.6%[P<0.0001]）。总的职业相关性为 3.7%，随时间呈显著下降趋势（从 1994-1996 年的 7.9%下降到 2013-2014 年的 1.9%[P<0.0001]）。珠宝是镍接触的最常见来源。